Epidermal growth factor receptor inhibitors for treatment of orbital squamous cell carcinoma.

Abstract

Orbitalandperiorbitalsquamouscell carcinomas (SCCs) are treated with surgicalresectionastheprimarymodality and radiation therapy as adjuvant treatment in patients with perineural invasion or concerns for microscopically positive margins. For advanced cases, extensive surgerysuchasorbitalexenterationmay be needed to fully extirpate the tumor. Orbital exenteration leads to loss of the eye and significant facial disfigurement but has the potential to produce long-term cure. The extensive surgical treatments required for advanced cases of orbital and periorbital SCC entail long periods of general anesthesia and inpatient hospitalization; thus, in patientswithpoorperformancestatus, advanced age, or multiple medical comorbidities, surgery may not be the best option. Several epidermal growth factor receptor(EGFR)inhibitorshaverecently been developed and have shownefficacyintreatmentofnon– small cell lung cancer, pancreatic cancer, colon cancer, and mucosal head and neck squamous cell carcinomas. 1-3 We herein report 2 elderly patients with recurrent advancedorbitalSCCwhoweretreated withEGFRinhibitors—erlotinib,an oral tyrosine kinase inhibitor, and cetuximab,amonoclonalantibody– and had striking initial responses to this treatment. Report of Cases.Case 1. A 90-yearold woman with a history of SCC of the left lateral canthus that had